Choosing a surgeon is a difficult decision. Often patients will choose whomever their primary care recommends. Alternatively patients make decisions based on what their friends have done and the results their friends or colleagues have had.
While these are reasonable reasons to choose someone, we will offer a few more suggestions to help you feel comfortable with your choice.
This advice pertains specifically to radical prostatectomy. This is a delicate surgery and your manhood could be riding on the results, not to mention curing your cancer.
That said, this advice is relevant to many types of surgery as a general rule.
First and foremost, find a surgeon with a lot of experience.
First and foremost, find a surgeon with a lot of experience. The number of cases he or she has done matters a lot. The more practice a surgeon gets, the better they are. And in this case, when your surgeon is getting their one shot at your case, they don’t get a second chance. You want the surgery to go smoothly. That means identifying problems before they happen, and avoiding them. This means the surgeon needs to have seen hundreds, if not thousands of these same cases.
Find a surgeon who has done at minimum 500 robotic radical prostatectomy surgeries. If he/she has done 1000 that’s even better.
Find a surgeon who graduated from residency or fellowship 4-5 years ago or more. A surgeon who just completed his/her training is not experienced. They might be talented, and they will almost certainly be friendly and good looking, but they will not be experienced. That comes with time.
The quality of the surgeon is not dependent on where they did their training.
The quality of the surgeon is not dependent on where they did their training. All urologists get good training, but the great surgeons learn by doing volume. While training at the best institutions is impressive, it is not necessary to be a great surgeon.
Consider who is actually going to be operating. Many great surgeons at academic institutions will have their junior residents or fellows do a substantial part of the surgery. It is important to ask during your interview who will actually be doing the surgery. This may seem intimidating to ask, but it’s your body, and you should know who is going to be working on you.
Prostate surgery is a delicate art. Urinary incontinence is one side effect, and great surgeons usually have great results with minimal incontinence. Not always, but usually. The exact effects of removing the prostate on erections (during radical prostatectomy for cancer) is not always known. Sometimes the patient will recover full erections, and often they will recover partial erections.The skill of the surgeon is one of the main factors in this outcome. If erectile function is important to you, then it’s important to find a skilled surgeon.
Your surgeon does not need to be nice. It’s more important that they can communicate well and that you trust them. If something doesn’t feel right, trust your instincts and find someone else.